Phosphorus is associated with coronary artery disease in patients with preserved renal function

Area of Science:

• Cardiology
• Nephrology
• Biochemistry

Background:

• Elevated serum phosphorus is a known risk factor for mortality and cardiovascular events, particularly in chronic kidney disease patients.
• In vitro studies suggest high phosphorus can induce vascular calcification and endothelial dysfunction.
• The relationship between phosphorus and coronary calcification in individuals with normal renal function requires further investigation.

Purpose of the Study:

• To investigate the association between serum phosphorus levels and coronary calcification and atherosclerosis.
• To evaluate this relationship in patients with preserved renal function (creatinine clearance >60 ml/min/1.73 m²).

Main Methods:

• Cross-sectional study of 290 patients undergoing elective coronary angiography for suspected coronary artery disease.
• Coronary artery calcification assessed using multislice computed tomography (Agatston score).
• Coronary artery obstruction evaluated by the Friesinger score; serum phosphorus and intact fibroblast growth factor 23 levels measured.

Main Results:

• Serum phosphorus was significantly higher in patients with Agatston scores >10 and Friesinger scores >4.
• Higher serum phosphate levels correlated with increased odds of coronary artery calcification and obstruction.
• Lower intact fibroblast growth factor 23 levels were associated with higher Friesinger scores.

Conclusions:

• Serum phosphorus is positively associated with coronary artery calcification and obstruction in patients with suspected coronary artery disease and normal renal function.
• Phosphorus may be an independent risk factor for coronary atherosclerosis in this population.
• Further research is warranted to explore the role of fibroblast growth factor 23 in this context.